Nerve Symptoms: Foot Tingling, Leg Cramps, and More

Tingling in the soles of the feet, leg numbness, and muscle twitching?

Hello Doctor,
1.
Symptom Description
A.
After sitting for a few seconds, I experience numbness, tingling, and a sensation like electric shocks in the soles of my feet, and sometimes there is a sudden sharp pain (like being shocked), along with occasional burning sensations in my feet.

B.
Frequent urination and a feeling of incomplete bladder emptying.

C.
Occasionally, my fingers also feel like they are being shocked.

D.
Sometimes, my calves and thighs feel numb or have a sensation like electric shocks, and there is muscle twitching (more frequent than before).

E.
My scalp is very prone to tingling.

F.
There is mild soreness in the sacral area (but not significant).

2.
Duration of Symptoms
A.
Numbness in the soles of my feet for nearly two months.

B.
Frequent urination and feeling of incomplete bladder emptying for about two weeks.

C.
The sensation of fingers being shocked for about one week.

D.
Numbness and muscle twitching in my calves and thighs for a little over a week.

E.
Scalp tingling for about one week.

F.
Mild soreness in the sacral area for about two months.

3.
Tests Conducted
A.
X-ray including forward bending and backward leaning => Normal.

B.
Full spine MRI => Normal.

C.
Nerve conduction study => Normal.

The neurologist referred me to rehabilitation medicine, and then from rehabilitation to neurosurgery, and the neurosurgeon asked me to return to neurology, which then referred me to another hospital...
The neurologist mentioned that he does not believe my symptoms resemble AIDP or CIDP, but he also stated that he could not determine the cause based on the test results.
I am uncertain about what is happening to me, and now it has become easier for my feet to feel numb (for example, I used to feel numb after sitting for a long time in the restroom, but now it happens more quickly).
Thank you for your assistance, Doctor.

Yīzhí bèi zhuǎnzhěn, 20~29 year old female. Ask Date: 2015/11/04

Dr. Lan Shengxing reply Neurology

Dear Mr.
"Constantly Being Referred," your examination results appear to be normal, so the neurologist's ability to assist you is limited.
I recommend that you seek treatment from the urology and rehabilitation departments.
Rehabilitation may take some time, so please be patient.
Best regards, Lan Shengxing.

Reply Date: 2015/11/04

More Info

Understanding nerve symptoms, particularly those affecting the feet and legs, can be complex and multifaceted. Based on your description, it seems you are experiencing a range of symptoms that include tingling, cramping, and sensations akin to electric shocks in various parts of your body. Let's break down these symptoms and explore potential underlying causes, as well as the importance of proper diagnosis and treatment.

Symptoms Overview
1. Tingling and Electric Sensations: The tingling and electric shock-like sensations in your feet and hands could indicate peripheral neuropathy, which is often caused by nerve damage. This condition can arise from various factors, including diabetes, vitamin deficiencies (especially B vitamins), alcohol use, and certain medications.

2. Muscle Cramps and Twitching: The muscle cramps and twitching you describe in your legs may be related to electrolyte imbalances, dehydration, or nerve irritation. Conditions such as restless leg syndrome or even anxiety can also contribute to these symptoms.

3. Frequent Urination and Incomplete Emptying: The urinary symptoms you mention could be linked to nerve issues affecting the bladder or pelvic floor. Conditions such as interstitial cystitis or even neurological disorders can manifest as urinary frequency or urgency.

4. Head and Lower Back Discomfort: The sensations in your scalp and lower back pain may also be connected to nerve issues, particularly if there is any compression or irritation of the spinal nerves. This could be due to structural issues in the spine, such as herniated discs or spinal stenosis.

Diagnostic Challenges
You mentioned undergoing various tests, including X-rays, MRI, and nerve conduction studies, all of which returned normal results. This can be frustrating, especially when symptoms persist. It's important to understand that not all nerve issues will show up on imaging or standard nerve conduction tests. Conditions like small fiber neuropathy, which affects the small nerve fibers responsible for pain and temperature sensation, may not be detected through conventional testing.

Potential Causes
Given the range of symptoms and their duration, several potential causes could be considered:
- Peripheral Neuropathy: As mentioned, this is a common condition that can arise from various underlying issues, including diabetes, vitamin deficiencies, and autoimmune disorders.

- Spinal Issues: Even with normal MRI results, subtle changes in the spine or nerve roots may not be apparent. Conditions like lumbar radiculopathy can cause symptoms in the legs due to nerve root compression.

- Systemic Conditions: Conditions such as multiple sclerosis (MS) or fibromyalgia could also present with similar symptoms, though these would typically be accompanied by other signs.

- Psychogenic Factors: Anxiety and stress can exacerbate physical symptoms, leading to increased awareness of bodily sensations and muscle tension.

Next Steps
1. Specialist Consultation: Given the complexity of your symptoms, it may be beneficial to consult with a neurologist who specializes in peripheral nerve disorders. They may consider additional tests, such as skin biopsies to assess small fiber function or blood tests for autoimmune markers.

2. Physical Therapy: Engaging in physical therapy may help address muscle cramps and improve overall function. A therapist can provide exercises tailored to your needs and help with posture, which may alleviate some discomfort.

3. Lifestyle Modifications: Ensuring proper hydration, maintaining a balanced diet rich in vitamins, and managing stress through relaxation techniques or counseling may also help mitigate symptoms.

4. Follow-Up: Regular follow-ups with your healthcare provider are essential to monitor your symptoms and adjust treatment plans as necessary.

Conclusion
Your symptoms warrant thorough investigation and a multidisciplinary approach to management. While it can be disheartening to receive inconclusive results, persistent symptoms should not be ignored. Collaborating with healthcare professionals who understand the complexities of nerve-related issues will be crucial in finding a path to relief and improved quality of life.

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